Provider Demographics
NPI:1184690935
Name:REID, YOLANDA G (MD)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:G
Last Name:REID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1460
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22402-1460
Mailing Address - Country:US
Mailing Address - Phone:540-786-2100
Mailing Address - Fax:540-786-6673
Practice Address - Street 1:2761 JEFFERSON DAVIS HWY STE 101
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-8330
Practice Address - Country:US
Practice Address - Phone:909-281-4720
Practice Address - Fax:951-808-5975
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101223707207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA183878OtherANTHEM
VA541595397OtherTRICARE
VA7516123OtherAETNA
VA541595397OtherVIRGINIA HEALTH NETWORK
VA27829OtherSENTARA/OPTIMA
VA010211689Medicaid
VAH26062Medicare UPIN
VA27829OtherSENTARA/OPTIMA